Provider Demographics
NPI:1952450652
Name:SHAH, RAKHI (DO)
Entity Type:Individual
Prefix:
First Name:RAKHI
Middle Name:
Last Name:SHAH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 DELNOR DR
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-4222
Mailing Address - Country:US
Mailing Address - Phone:630-208-0784
Mailing Address - Fax:630-208-0981
Practice Address - Street 1:351 DELNOR DR
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-4222
Practice Address - Country:US
Practice Address - Phone:630-208-0784
Practice Address - Fax:630-208-0981
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036115135207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400231118OtherMEDICARE INDIVIDUAL
IL1376643767OtherGROUP NPI
IL206147OtherMEDICARE GROUP
IL036115135Medicaid